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Kim, Kim, Son, and Park: Soft tissue changes associated with advancement genioplasty in skeletal class III individuals receiving mandibular set-back surgery
Original Article
Korean Journal of Orthodontics

Korean Journal of Orthodontics 2008; 38(2): 104-120.

Published online: 30 April 2008

DOI: https://doi.org/10.4041/kjod.2008.38.2.104

Soft tissue changes associated with advancement genioplasty in skeletal class III individuals receiving mandibular set-back surgery

Keun-Ryoung Kim, DDS, MSDa, Seong-Sik Kim, DDS, MSD, PhDb, Woo-Sung Son, DDS, MSD, PhDc, Soo-Byung Park, DDS, MSD, PhDc

aPostgraduate student, Department of Orthodontics, School of Dentistry, Pusan National University, Korea.

bAssociate Professor, Department of Orthodontics, School of Dentistry, Pusan National University, Korea.

cProfessor, Department of Orthodontics, School of Dentistry, Pusan National University, Korea.

Corresponding author: Seong-Sik Kim. Department of Orthodontics, School of Dentistry, Pusan National University, Gu-Deok-Ro 305, Seo-Gu, Busan 623-739, Korea. +82 51 240 7443; softid@pusan.ac.kr

Received 26 December 2007       Revised 29 February 2008       Accepted 2 March 2008

Copyright © 2008 Korean Association of Orthodontists

Abstract

Purpose

The purpose of this study was to assess the hard and soft tissue changes associated with mandibular bilateral sagittal split osteotomy and genioplasty.

Methods

This is a retrospective study of 40 patients who underwent either bilateral sagittal split osteotomy for mandibular setback (BSSO group, n = 20) or in combination with advancement genioplasty (Genio group, n = 20). Lateral radiographs, were taken before and immediately after surgery, and at least 6 months after surgery.

Results

Comparing hard and soft tissue changes between the BSSO group and Genio group, there were significant differences in the lower incisor, soft tissue B point (B'), and soft tissue Pogonion (Pg') (p < 0.5). The mean ratio of hard and soft tissue changes for B/B', Pg/Pg', and Menton/soft tissue Menton after surgery in the BSSO group was 0.997, 0.965, and 1.022 respectively, and 0.824, 0.602, and 0.887 respectively in the genio group. Significant differences were found between the two groups. There were significant differences in lip thickness (B-B', Pg-Pg') in the Genioplasty group between pre and postsurgery, but not in the BSSO group. Pogonion to Labrale inferior and B' had a correlation coefficient of 0.833, 0.922, respectively for the BSSO group, and 0.775, 0.799 for the Genio group.

Conclusions

The results indicate that there is a significant difference between bilateral sagittal split osteotomy with or without genioplasty in the lower facial esthetics values. The combination of mandibular setback and genioplasty had a smaller change in soft tissue thickness of the symphysis area after surgery than that of mandibular setback only.

Keywords: Advancement genioplasty, Soft tissue change, Mandibular prognathism

Figures and Tables

Fig 1
Cephalometric landmarks of hard and soft tissue points and associated reference planes. 1, U1 ; 2, L1; 3, infra; 4, B; 5, Pg; 6, Me; 7, Stos; 8, Stoi; 9, Li; 10, B'; 11, Pg'; 12, Me'; 13, S; 14, Na.
kjod-38-104-g001
Fig 2
Horizontal measurements of hard tissue landmarks. 1, U1; 2, L1; 3, infra; 4, B; 5, Pg; 6, Me.
kjod-38-104-g002
Fig 4
Vertical measurements of hard tissue landmarks. 13, U1; 14, L1; 15, infra; 16, B; 17, Pg; 18, Me.
kjod-38-104-g004
Fig 5
Vertical measurements of soft tissue landmarks. 19, Stos; 20, Stoi; 21, Li; 22, B'; 23, Pg'; 24, Me'.
kjod-38-104-g005
Fig 6
Lip thickness measurements. 25, U1-Li; 26, L1-Li; 27, Infra-B'; 28, B-B'; 29, Pg-Pg'; 30, U1-Stoi; 31, L1-Stoi.
kjod-38-104-g006
Fig 7
Lip length measurements. 32, Me-Me'; 33, Me'-Stoi.
kjod-38-104-g007
Fig 8
Mean treatment changes (T1 - T3) in lip thickness (uint: mm).
kjod-38-104-g008
Table 1
Case selection criteria
kjod-38-104-i001
Table 2
Descriptive patient information
kjod-38-104-i002
Table 3
Definitions of hard and soft tissue landmarks
kjod-38-104-i003
Table 4
Measurements of hard and soft tissue landmarks
kjod-38-104-i004
Table 5
Hard tissue landmark changes in BSSO group (unit: mm)
kjod-38-104-i005

SD, Standard deviation; *p < 0.05.

Table 6
Hard tissue landmark changes in Genio group (unit: mm)
kjod-38-104-i006

SD, Standard deviation; *p < 0.05.

Table 7
Horizontal changes of Hard and soft tissue landmarks between each group (T1 - T3) (unit: mm)
kjod-38-104-i007

SD, Standard deviation; *p < 0.05.

Table 8
Vertical changes of Hard and soft tissue landmarks between each group (T1 - T3) (unit: mm)
kjod-38-104-i008

SD, Standard deviation; *p < 0.05.

Table 9
Mean treatment changes (T1-T3) in lip dimensions (unit: mm)
kjod-38-104-i009

SD, Standard deviation; *p < 0.05.

Table 10
Sexual differences of mean treatment changes between each group (T1 - T3) (unit: mm)
kjod-38-104-i010

NS, Statistically not significant; *p < 0.05.

Table 11
Correlation coefficients between hard tissue and soft tissue horizontal changes for each group (T1 - T3)
kjod-38-104-i011

*p < 0.05; †p < 0.01.

Table 12
Correlation coefficients between hard tissue and soft tissue vertical changes for each group (T1 - T3)
kjod-38-104-i012

*p < 0.05; †p < 0.01.

Table 13
Ratio of horizontal and vertical changes of soft tissue as percentage of hard tissue changes
kjod-38-104-i013

ΔH, Horizontal changes (T1 - T3); ΔV, Vertical changes (T1 - T3).

Notes

This study was supported by Pusan Orthodontic Society Research Grant.

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